Traini Emanuela, Ianni Francesca, Vergani Edoardo, Carnassale Giulia, Daloiso Giuseppe, Mancini Antonio, Silvestrini Andrea
Ospedale San Carlo di Nancy, GVM Care and Research, 00168 Roma, Italy.
Unità Operativa Medicina Interna, Endocrinologia e Diabetologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
Int J Mol Sci. 2025 May 9;26(10):4521. doi: 10.3390/ijms26104521.
It is known that a percentage of patients who undergo total thyroidectomy, approximately 16-34%, complain of symptoms of hypothyroidism or altered quality of life (QoL) despite achieving normal serum TSH values. The present study aimed to identify whether the level of selenium could be responsible for this phenomenon. This pilot cohort study included 44 thyroidectomized outpatients. All patients underwent surgery for benign disease. In this study, no patients with a history of autoimmunity, malignancy, or other conditions that could affect well-being, absorption, or selenium intake were included. Serum levels of TSH, fT3, fT4, Selenoprotein P (SelP), and glutathione peroxidase 3 (GPx3) were measured. The patients also completed the ThyPRO-39 questionnaire to assess their QoL. A strong and significant direct correlation was found between SelP and GPx3 (r = 0.88). However, no correlation was found between hormonal status and SelP or GPx3. Analysis of ThyPRO-39 results did not show clinically significant differences between items nor a correlation with thyroid hormone levels, except for symptoms of hypothyroidism. Interestingly, a significant direct correlation was observed between SelP and tiredness, as well as between GPx3 and tiredness. Furthermore, the fT3/fT4 ratio was correlated with worsening symptoms of hypothyroidism. The results suggest that the selenium status, in turn related to antioxidant activities, as reflected in SelP and GPx3 levels, may be associated with the QoL tiredness domain in thyroidectomized patients, despite normal levels of thyroid hormones. More research is needed to elucidate the role of selenium in the persistent symptoms experienced by some thyroidectomized patients.
已知约16 - 34%接受全甲状腺切除术的患者，尽管血清促甲状腺激素（TSH）值正常，但仍抱怨有甲状腺功能减退症状或生活质量（QoL）改变。本研究旨在确定硒水平是否可能是导致这一现象的原因。这项前瞻性队列研究纳入了44例甲状腺切除术后的门诊患者。所有患者均因良性疾病接受手术。本研究未纳入有自身免疫病史、恶性肿瘤或其他可能影响健康、吸收或硒摄入情况的患者。测量了血清TSH、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、硒蛋白P（SelP）和谷胱甘肽过氧化物酶3（GPx3）水平。患者还完成了ThyPRO - 39问卷以评估其生活质量。发现SelP与GPx3之间存在强且显著的正相关（r = 0.88）。然而，激素状态与SelP或GPx3之间未发现相关性。对ThyPRO - 39结果的分析未显示各项目之间存在临床显著差异，也未显示与甲状腺激素水平存在相关性，但甲状腺功能减退症状除外。有趣的是，观察到SelP与疲劳之间以及GPx3与疲劳之间存在显著的正相关。此外，fT3/fT4比值与甲状腺功能减退症状加重相关。结果表明，尽管甲状腺激素水平正常，但反映在SelP和GPx3水平上的与抗氧化活性相关的硒状态，可能与甲状腺切除患者的生活质量疲劳领域相关。需要更多研究来阐明硒在一些甲状腺切除患者持续症状中所起的作用。
